Symptomatic severe aortic stenosis is associated with high mortality rates, up to 50% at 1 year, 1 and the prevalence will likely increase as the population ages. 2 Until recently, surgical valve replacement was the only durable therapeutic option; however, many older patients with aortic stenosis have prohibitive surgical risk. Transcatheter aortic valve replacement (TAVR) has emerged as an. The annual incidence of sudden death has been reported to be low (<1%/year) in asymptomatic patients with severe aortic stenosis (AS), and there is a paucity of data on the risk factors of sudden death in patients with severe AS . However in a study assessing the causes of death in 387 young athletes, aortic valve stenosis was identified as the reason of death in 10 athletes (6) Consistently, prospective registry data reported a mortality rate of 55% at 1 year in 78 patients with severe aortic stenosis undergoing conservative management. The rapid spread of the SARS-CoV-2 pandemic represents an unprecedented challenge for healthcare systems
mated surgical mortality.60 Overall 30-day sur-gical mortality is less than 3% for isolated aortic-valve replacement and approximately 4.5% for aortic-valve replacement with coronary-artery bypass grafting. After recovery from successful aortic-valve replacement, the rate of overall sur-vival is similar to that among age-matched adults without aortic stenosis As you can see, the STS benchmark shows that the national average for aortic valve replacement operative mortality is 2.7 percent. At The Cleveland Clinic, the mortality rate is significantly below that average at 1.1 percent Aims: Resting heart rate (HRate) is a modifiable risk factor among patients with cardiovascular disease, including aortic stenosis (AS). However, the effect of resting HRate on clinical outcomes of patients with severe symptomatic AS undergoing transcatheter aortic valve implantation (TAVI) is unknown Aortic valve replacement is the only effective treatment for hemodynamically significant aortic stenosis. The surgery has an average perioperative mortality rate of 4 percent 21 - 23 and a risk of.. Similarly, the moderate aortic stenosis group (mean gradient, 20 to 39 mm Hg; peak velocity 3 to 3.9 m/s) had a 5-year mortality rate of 56%. We are entering a new era of aortic valve stenosis..
Aortic stenosis-related mortality rates in the US regions by age and sex, 2008 to 2018. A consistent reduction in mortality was noted in women (AAPC, −1.0 [95% CI, −1.5 to −0.4]) and men (AAPC, −1.0 [95% CI, −1.4 to −0.46]), because of accelerated mortality decline since 2015 in women and 2014 in men into subsequent years. Objectives: This study aimed to assess the value of low transvalvular flow rate (FR) for the prediction of mortality compared with low stroke volume index (SVi) in patients with low-gradient (mean gradient: <40 mm Hg), low aortic valve area (<1 cm 2) aortic stenosis (AS) following aortic valve intervention. Background: Transaortic FR defined as stroke volume/left ventricular ejection time is. Multivariable predictors of mortality (aortic valve replacement censored) with echocardiographic data as continuous and categorical variables in the entire population. eTable 3. Multivariate analysis of cardiovascular mortality in patients with severe aortic stenosis with substitution of peak aortic velocity by aortic valve area (categorical data) About 50% of these patients with mild to moderate stenosis at baseline had progressive valve calcification leading to haemodynamically severe aortic stenosis (defined as an aortic jet velocity >4.0m/s) and 18% required valve replacement for onset of aortic stenosis symptoms. The average rate of increase in aortic jet velocity of 0.24±0.30m/s.
Syncope (fainting spells) from aortic valve stenosis is usually exertional. In the setting of heart failure it increases the risk of death. In people with syncope, the three-year mortality rate is 50% if the aortic valve is not replaced. It is unclear why aortic stenosis causes syncope Aortic stenosis is a narrowing of the aortic valve opening. Aortic stenosis restricts the blood flow from the left ventricle to the aorta and may also affect the pressure in the left atrium. Although some people have aortic stenosis because of a congenital heart defect called a bicuspid aortic valve, this condition more commonly develops during. DOI: 10.1056/NEJMra1313875. Aortic-valve stenosis is a progressive condition; end-stage disease leads to death due to obstruction of left ventricular outflow. Aortic-valve replacement is the only. Survival in people with aortic stenosis depends on the type of symptoms they have. In people with chest pain, the average survival rate is about five years. If the person is passing out (syncope), the survival rate drops to three years. The average survival rate of people with congestive heart failure is two years Introduction. Aortic stenosis (AS) is predominantly a disease of the elderly, with significant mortality and morbidity. The only definitive therapy is aortic valve replacement (AVR) and surgical units operating on large numbers of elderly patients have reported reasonable operative mortality rates of <10%. 1-9 Some of these studies have concluded that patients who undergo AVR have better.
Aortic stenosis is the obstruction of blood flow across the aortic valve (see the image below). Among symptomatic patients with medically treated moderate-to-severe aortic stenosis, mortality from.. Aortic valve stenosis is a defect that narrows or obstructs the aortic valve opening, making it difficult for the heart to pump blood into the body's main artery (aorta). Typically the aortic valve has three tightly fitting, triangular-shaped flaps of tissue called cusps (tricuspid aortic valve) Management. In asymptomatic patients with mild to moderate aortic stenosis, the survival is similar to age-matched controls. [1,16] The mainstay of medical treatment for these patients is simply. Monica was born with a bicuspid aortic valve, which means the valve may not fully open because it has two flaps instead of three. Neighbors Monica and Alexis have enjoyed keeping fit together for years. Although they've been consistent running buddies for the last two years, over the last few weeks, Monica just doesn't seem able to keep up
The mortality from aortic stenosis dramatically increases once symptoms develop. No medical therapy exists to halt or reverse the disease process, and aortic valve replacement (AVR) is the. balloon aortic valvuloplasty studies, which yielded a rate of 12-month all-cause mortality or major stroke of 42.7% (95% CI 34.0% to 51.4%); and (2) an adjusted estimate based on the lower 95% confidence bound of 43% in the standard therapy arm of inoperable patients in th Aortic stenosis is a heart disease that is present at birth. Dogs affected with aortic stenosis have a narrowing at the aortic valve of the heart. This narrowing forces the heart to work abnormally hard to force blood through the narrowed valve. The clinical signs of aortic stenosis vary depending on how severe the stenosis is; some dogs remain asymptomatic throughout their life, while other. After the onset of symptoms, patients with severe aortic stenosis have a survival rate as low as 50% at 2 years and 20% at 5 years without aortic valve replacement. 4 Learn more about why severe aortic stenosis is dangerous and how to recognize the symptoms of this serious disease In order to provide clarity about the risk of sudden death in asymptomatic adults with AS, Minners and colleagues examined the data from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. 2 In this cohort of 1849 patients with mild to moderate AS, sudden cardiac death occurred in 1.5% at a mean of 2.3 years after study enrolment
Introduction. Cancer and cardiovascular disease are the two leading causes of mortality in the United States ().Patients with both cancer and aortic stenosis (AS), are exposed to factors that could potentially accelerate AS progression, including chest radiation (2, 3) and cardiotoxic drugs such as anthracyclines ().These have been noted to produce de-novo AS via valve leaflet thickening. Intermediate-risk patients with severe aortic stenosis who receive minimally invasive transcatheter aortic valve replacement, known as TAVR, have similar rates of death and disabling strokes after two years compared with those undergoing standard open heart surgical replacement, according to a study presented at the American College of Cardiology's 65 th Annual Scientific Session Objective We retrospectively analysed outcome data from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study to assess the incidence and potential risk factors of sudden cardiac death (SCD) in this prospectively followed cohort of asymptomatic patients with aortic stenosis (AS). Methods Of the 1873 patients included in SEAS, 1849 (99%) with mild to moderate AS (jet velocity 2.5-4.0. Aortic valve stenosis (AS) is a progressive condition characterized by gradual calcification of the aortic cusps. Progression rate evaluated using echocardiography has been associated with survival. However, data from routine practice covering the whole spectrum of AS severity and the rate of symptom onset are sparse
Decisions about the timing of surgery for people with asymptomatic aortic stenosis must balance the risks of intervention against the possible harms of watchful waiting. Among the latter is the possibility of sudden cardiac death which, according to a recent longitudinal study, is small but not negligible. Among 1849 asymptomatic people, 27 sudden cardiac deaths occurred over four years of. However, the echocardiographic severity of aortic stenosis at baseline along with the rate of change over time were predictors of clinical outcome—death or need for valve surgery. Overall, with respect to the rate of progression of acquired valvular aortic stenosis, on average, the aortic valve area decreases by approximately 0.1 cm 2 /yr and. It leads to congestive heart failure and death (at a rate of 50% within two years). Severe aortic stenosis Loffler, who had spent several years in a heart valve clinic and cardiac electrophysiology clinic before practicing with UCHealth, knew that patients — no matter how intelligent — often struggle with the complexity of cardiac. patients with severe aortic stenosis face a 17.3% risk of cardiac complications and a 13% mortality rate during noncardiac surgery. Despite impressive ad-vances in anesthesiologic techniques during the past few years, the risks of noncardiac surgery in patients with aortic stenosis remain high (Table 2),12-15,38,39 as follows Aortic stenosis (AS) is common in patients on dialysis as well as in the general population. AS leads to difficulty with dialysis therapy because of unstable conditions such as intradialytic hypotension due to low cardiac output. However, the precise morbidity rates and risk factors of AS in patients on dialysis are unknown. Moreover, there are no large-scale observational studies regarding.
U.S. Aortic Stenosis Disease Prevalence & Treatment Statistics. Heart disease is the leading cause of death in the U.S., killing more than 600,000 Americans each year. 1 More than five million Americans are diagnosed with heart valve disease each year. 2 Heart valve disease can occur in any single valve or a combination of the four valves, but diseases of the aortic and mitral valves are the. They focused on age-adjusted mortality rates from 2008 through 2018 in order to assess the impact of growing use of TAVR following its initial FDA approval in 2012. Findings showed that overall age-adjusted mortality from aortic stenosis declined from 12.7 per 100,000 people in 2008 to 11.5 in 2018. Notably, whereas age-adjusted mortality was.
Perspective: These relatively long-term follow-up data from a multicenter, randomized trial of TAVR vs. SAVR in patients ≥70 years of age with severe symptomatic aortic stenosis at low operative risk suggest similar clinical outcomes in terms of all-cause mortality, stroke, or MI; superior hemodynamics and lower risk of SVD after TAVR; and similar risk between groups of bioprosthetic valve. Avoiding needless deaths in aortic stenosis. Echocardiography is key for the assessment of aortic stenosis (AS), but taking a good history is also crucial and requires specialist competency. Symptomatic AS requires surgery and, if physicians miss the onset of symptoms, the risk of death rises from 1% per annum in patients without symptoms to 14. .0cm 2 is not an independent predictor of mortality related to aortic stenosis and is therefore not a valid defining feature of severe aortic stenosis. Flow rate assessment should be incorporated into diagnosis, classification and prognosis schema for aortic stenosis Lightheadedness, feeling dizzy, and/or fainting. Difficulty when exercising. Swollen ankles and feet. Rapid or irregular heartbeat. Up to 50% of people who develop severe aortic stenosis symptoms will die within an average of two years if they do not have their aortic valve replaced. 3. icon-caregiver-tip-hands Aortic valve area (AVA) is a central criterion for assessing the severity of aortic stenosis (AS). Severe AS is defined as both low AVA (≤1.0 cm 2 in Europe, <1.0 cm 2 in the U.S.) and high mean gradient (≥40 mm Hg).. AVA is highly dependent on the transvalvular flow rate (Q), the average volume of blood passing through the aortic valve per unit of time during ventricular ejection
The rate of progression of stenosis, as reflected by the aortic-jet velocity, was significantly higher in patients who had cardiac events (0.45±0.38 m per second per year) than those who did not. Sudden death occurs in patients with congenital supravalvular aortic stenosis (SVAS) associated with Williams-Beuren syndrome (WS) and nonsyndromic SVAS at a rate higher than the general population. In addition, it is generally acknowledged that SVAS patients are at increased risk of sudden death when undergoing diagnostic or surgical procedures For those patients with mild or moderate stenosis, the aortic valve area decreases on average by 0.1 cm²/year and the mean gradient increases by 7 mmHg annually. Faggiano P, Ghizzoni G, Sorgato A, et al. Rate of progression of valvular aortic stenosis in adults Aortic stenosis is one of the most common and serious types of heart valve disease. Aortic stenosis can be debilitating, costly, and deadly. Survival rates without treatment for severe symptomatic aortic stenosis are low at 50% at 2 years after symptom onset, and 20% at 5 years
In critically ill patients, the mortality rate associated with the procedure is 3-7%. Another 6% develop serious complications, including perforation, myocardial infarction, and severe aortic. INTRODUCTION. Aortic valve stenosis is the most common cause of left ventricular outflow obstruction in children and adults; less common causes are subvalvular or supravalvular disease ().This topic will review the clinical features, diagnosis, and evaluation of valvular aortic stenosis (AS) .The pathogenesis, epidemiology, natural history, medical therapy, and percutaneous and surgical. Survival of patients with moderate aortic stenosis according to rate of aortic stenosis progression (Vmax > 0.3 m/s/y vs. ≤ 0.3 m/s/y) in patients with available echocardiographic follow-up (N = 505). (A) Observed survival free of death. (B) Observed survival free of death or heart failure (HF) hospitalization
Effects of incoordination on left ventricular force-velocity relation in aortic stenosis. Heart 1996; 76:495. Cheitlin MD, Gertz EW, Brundage BH, et al. Rate of progression of severity of valvular aortic stenosis in the adult. Am Heart J 1979; 98:689. Wagner S, Selzer A. Patterns of progression of aortic stenosis: a longitudinal hemodynamic study Low dσ*/dtmax < 2.8 s−1 was independently associated with a higher composite outcome of aortic valve replacement, congestive cardiac failure admissions and all-cause mortality (adjusted hazard.
Without treatment, symptomatic aortic stenosis will eventually lead to death. 6. Without treatment survival rates in patients with severe aortic stenosis are as low as 50% at two years. Learn More About The Treatment Options For Aortic Stenosis For Australian Since the first transcatheter aortic valve replacement (TAVR) in 2002  percutaneous therapy of aortic valve stenosis (AS) has evolved rapidly.Today, TAVR is the first option for older patients with AS at intermediate or high risk for surgery [2,3].Constant development of bioprosthetic valves and delivery systems have reduced complication rates and improved outcomes over the years [4,5,6,7] At 30 days, mortality rates were similar in patients with bicuspid and tricuspid anatomy (2.6% vs 2.5%; P = 0.82), while the risk of stroke was higher among those with bicuspid aortic stenosis (2.5% vs 1.6%; P = 0.02). At 1 year, mortality and stroke risks were similar between the patient groups Medical uses. Patients with symptomatic severe aortic stenosis have a mortality rate of approximately 50% at 2 years without intervention. In patients who are deemed too high risk for open heart surgery, TAVR significantly reduces the rates of death and cardiac symptoms. At present, TAVR is not routinely recommended for low risk patients in favor of surgical aortic valve replacement, however.
The treatment plan for your aortic stenosis depends on how severe your condition is. If your case is mild or moderate, your doctor may decide to keep an eye on how you're doing for a while In an older child, severe aortic stenosis rarely causes heart failure. The child may experience chest pain, lightheadedness or fainting spells particularly associated with exercise. Severe aortic stenosis is a rare, but well-documented, cause of sudden death during strenuous sports activities. Diagnosis of Aortic Stenosis
Undetected, severe aortic valve stenosis is a known cause of sudden death and accounts for approximately 1% of all causes of sudden death in young people. A retrospective cohort study in 245 patients with congenital valvular aortic stenosis by Ten Harkel et al found that mortality was high for patients who were diagnosed in infancy but was. The incidence of aortic stenosis increases with age, with about 29% of cases occurring in individuals aged 65 and older and about 37% occurring in individuals aged 75+ . Known for its poor prognosis, aortic stenosis has a one-year survival rate of about 60% and a five-year rate of about 32% Aortic stenosis represents 34% of the native valvular diseases in industrialized nations, and is the most common primary valve disease requiring surgery or transcatheter intervention in Europe and North America. 1,2 Of the 146,304 deaths in the U.S. from aortic valve disease (ICD-10 data from 1999 to 2009), 82.7% were from aortic stenosis. 3
In symptomatic patients with moderate to severe AS, the mortality rate is as high as 25% in 1 year and 50% in 2 years. The definitive treatment for AS is surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) Aortic stenosis was also associated with higher morbidity and mortality rates than were diseases involving other cardiac valves. 4 For example, in a study 5 of 161 patients, patients with moderate and severe aortic stenosis had 2-year mortality rates of 40.2% and 58.2%, respectively surgery in patients with aortic stenosis. To meet this challenge, one requires an accurate knowledge of the natural history and rate of progression of the disease. This review will summarize the natural history ofaortic stenosis in terms ofsymptoms, mortality, and stenosis progression. (CHEST1998; 113:1109-14) Keywords: aortic stenosis; natural. In 323 patients with severe AS and high operative risk (logistic EuroSCORE 28.7 ± 12.5%) who underwent balloon aortic valvuloplasty, the rate of major in-hospital complications was 6.8% and in-hospital mortality was 2.5%. 65 After this treatment, 65% of patients continued medical treatment while the remaining patients were bridged to SAVR or TAVI Aortic valve replacement in elderly tied to high mortality. (HealthDay)—The 10-year mortality rate in elderly patients who receive surgical aortic valve replacement (SAVR) is considerable.
Aortic stenosis is a common valvular disorder, especially in the elderly population, causing left ventricular outflow obstruction. Etiologies include congenital (bicuspid/unicuspid), calcific, and rheumatic disease. Symptoms such as exertional dyspnea or fatigue gradually develop after a long asymptomatic latent period of about 10 to 20 years 1585. Getty. In aortic stenosis, your aortic heart valve does not let enough blood flow out of your heart to the aorta, the main artery that carries blood to your body. This deprives your body of needed oxygen. Over time, you can feel tired more easily, short of breath, or weak or faint—all symptoms that can affect your quality of life The asymptomatic patient has a good outlook even with severe obstruction, whereas an individual with symptoms has a mortality rate of about 25% per year. Thus, knowing how the pathophysiology of aortic stenosis causes symptoms and death is paramount to understanding the disease In summary, this patient has clinically severe aortic stenosis complicated by left ventricular dilation. There is no evidence of infective endocarditis or haemolytic anaemia. The most common cause would be degenerative calcification of the aortic valve Efficient medical treatment of aortic stenosis does not exist. Life expectancy with onset of symptoms is approximately 3 years, and only 1year in those after the onset of congestive heart failure. Surgical in-hospital mortality rate is approximately 3%
Aortic stenosis (AVS) is a narrowing of the aortic valve, which is the valve that lets blood flow from the lower-left chamber (the left ventricle) to all parts of the body. When the aortic valve is narrowed, the left ventricle has to pump harder to force blood through the valve. Working too hard may cause the left ventricle to get larger, which. The mortality rate is approximately 25% per year among symptomatic patients (Figure 149-2), with three quarters of those whose AS is untreated dying within 3 years of the onset of symptoms (Figure 149-3). Asymptomatic patients, on the other hand, even those with severe disease, have a more favorable outlook (risk of death <1% per year) Notably, patients with moderate aortic stenosis had a similar risk profile of cardiovascular morbidity and mortality to those with severe aortic stenosis. 13.•• van Gils L, Clavel MA, Vollema EM, Hahn RT, Spitzer E, Delgado V, et al. Prognostic implications of moderate aortic stenosis in patients with left ventricular systolic dysfunction Left untreated, severe aortic stenosis can eventually lead to heart failure, severe infection and even sudden death. 4 From the onset of aortic stenosis symptoms, the average survival rate is 50 percent at two years 5 and 20 percent at five years. Aortic stenosis (AS) and atrial fibrillation (AFib) are two conditions associated with high cardiovascular morbidity and mortality [1-5].The incidences increase with age and as populations are ageing; both conditions are likely to become a greater public burden [1, 2, 6].The left ventricular (LV) response to AS is hypertrophy, impaired relaxation, increased diastolic filling pressure and.
Low-flow low-gradient (LF-LG) aortic stenosis (AS) is associated with high mortality, even after transcatheter aortic valve replacement (TAVR). Further knowledge of risk indicators is needed and a clinical risk score would be desirable for optimizing patient selection and therapeutic strategy. The study cohort comprised of 219 consecutive LF-LG AS patients undergoing TAVR from 2008 to 2018 in. Aortic stenosis means that your child has a heart valve that is too narrow or is blocked. The aortic valve is 1 of 4 heart valves that keep blood flowing through the heart. The valves make sure blood flows in only one direction. The aortic valve keeps blood flowing from the left ventricle to the aorta Mild Aortic Stenosis. Aortic stenosis is tightening of the aortic valve and mild aortic stenosis is a mild tightening. As we said above the usual aortic valve area is like a medium sized wristwatch around 3-4 cm 2 in area. Generally, in mild aortic stenosis, the tight valve remains greater than 1.5-2 cm 2. Interestingly, this means the valve. The major symptoms of aortic stenosis are: chest pain ( angina ), fainting ( syncope ), and. shortness of breath (due to heart failure). In a low percentage of the patients with aortic stenosis, the first symptom is sudden death, usually during strenuous exertion. The exact reason for sudden death is unknown Aortic stenosis and pregnancy. Arias F, Pineda J. Pregnancy in patients with aortic stenosis results in a maternal mortality rate of 17.4% and perinatal mortality rate of 31.6%. Medical treatment, valve replacement and termination of pregnancy are the main modes of therapy
After a median follow-up of 4.9 years (IQR 3.0-8.2), patients with discordant grading had lower aortic valve replacement rates (26.7% vs 44.1%, p<0.001) and higher mortality rates (60.0% vs 43.1%, p<0.001) as compared with patients with concordant grading Objective To examine the clinical significance and prognostic value of an early rapid rise in heart rate (RR-HR) in asymptomatic patients with moderate or severe aortic stenosis (AS). Methods We retrospectively assessed the prospectively collected data from 306 patients (age 65±12 years, 33% women) with moderate (n=204) or severe AS (n=102) with a median follow-up of 25 months (mean 34.9±34. During a median follow-up of 1198 days, 5-year mortality rates for patients with mild, moderate, and severe AS were 34%, 43%, and 53%, respectively. Analyses adjusting for age, sex, left ventricular systolic dysfunction, diastolic dysfunction, and aortic regurgitation showed a striking, >50% increased risk for all-cause 5-year mortality in. Aortic stenosis may be present from birth (congenital), but most often it develops later in life. Children with aortic stenosis may have other conditions present from birth. Aortic stenosis mainly occurs due to the buildup of calcium deposits that narrow the valve. This is called calcific aortic stenosis. The problem mostly affects older people A ortic stenosis is the most common valvular heart condition in the developed world, affecting 3% of people between ages 75 and 85 1 and 4% of people over age 85. 2 Aortic valve replacement remains the only treatment proven to reduce the rates of mortality and morbidity in this condition. 3 Under current guidelines, 4,5 the onset of symptoms of exertional angina, syncope, or dyspnea in a.
This is called aortic regurgitation. Your aortic valve does not open fully, so blood flow out of the heart is reduced. This is called aortic stenosis. The aortic valve can be replaced using: Minimally invasive aortic valve surgery, done using one or more small cuts. Open aortic valve surgery, done by making a large cut in your chest Aortic valve stenosis or aortic stenosis is a heart condition where the heart's aortic valve narrows making it harder for the heart to pump blood through the aortic valve. The word stenosis means constriction or narrowing. In aortic stenosis, the aortic valve is narrowed. The aortic valve is like a one-way door leading out of the heart In patients with severe aortic stenosis transfemoral TAVI with the Edwards Sapien 3 valve without general anesthesia was associated with a high rate of device success, no moderate or severe residual aortic regurgitation, low rates of major vascular complication, mortality and stroke within 30 days with no difference between the 3 valve sizes Aortic stenosis is one of the most common heart valve defects. Transcatheter aortic valve replacement procedures had a high rate of success and low risk of death or disabling stroke at 30 days. Aortic stenosis does not cause substantial morbidity or mortality when the disease is mild or moderate in severity. By the time it becomes severe, there is an untreated mortality rate of approximately 50% within 2 years.4, Open surgical repair is an effective treatment for reversin
Furthermore, for our low-risk patients (n=771) with a STS <4 % risk the mortality rate was 0.3 % between 2011 and 2013, and for 74 % intermediate or high-risk there were no deaths (0 %) for a total of 0.2 % death (n=956 patients) The risk factors for aortic valve stenosis include: Gender. Men have a higher risk of aortic valve stenosis than women. The condition occurs most often in men between the ages of 30 and 60 Among high and extreme risk patients with aortic stenosis, the Portico valve had a higher rate of safety endpoint events, including mortality, than did commercial valves at 30 days, but similar rates of death or disabling stroke at 2 years